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Editor’s blog Tuesday 27 April 2010: Gordon Brown the nurse manager post-May 6, and Labour’s comedy health manifesto | Health Policy Insight
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Editor’s blog Tuesday 27 April 2010: Gordon Brown the nurse manager post-May 6, and Labour’s comedy health manifesto

Publish Date/Time: 
04/27/2010 - 09:35

If Gordon Brown wants a new job come May 7, he could retrain to be a nurse manager. He successfully managed to get RCN activists off their arses twice in one afternoon yesterday.

We guarantee something you can’t legally enforce
This comes on the back of the comically odd new Labour health manifesto, Your Personal NHS Guarantee, launched yesterday.

In the foreword to this document, Brown writes, “Labour will fight for a better NHS - for an NHS on the side of the patient, not the system. This is Labour’s personal NHS guarantee to you".

Cah. What cowboy’s been in office this past 13 years, eh?

’It seems unaware of any potential dissonance between the pledge to “cut red tape and bureaucracy, reduce management costs by a third” and the “guarantee of no return to … low standards”.’

The manifesto apes the entirely pointless NHS Constitution in attempting to persuade the gullible that its “guarantees” are legally enforceable rights.

It seems unaware of any potential dissonance between the pledge to “cut red tape and bureaucracy, reduce management costs by a third” and the “guarantee of no return to … low standards”.

Did you say ‘no return to low standards’?
Nor is there any acknowledgment that in parts of the NHS, it would not be a question of a return to low standards. Too many services have not improved.

Ask the populations affected in Maidstone and Tunbridge Wells, Mid-Staffs, Basildon and Thurrock – or those facing pathology screening in Bristol.

This is a manifesto, and so it’s wrong of me to want details about the practical workings of the (wholly sensible) plan to “extend individual budgets for those receiving treatment for a long-term or chronic condition through which their care package is purchased”.

But I do want details. In fact, we need to know what is planned here – top ups, overspending, indicative budgets: it all matters as to whether this will fly or crash.

The good bits
The personal and preventative sections are mostly sensible.

The ridiculous bits
They are apparently going to “extend” the staff right to request to run social enterprises. You know, the right that already exists. So that’ll help.

And they seriously propose that setting a target for the number of Foundation Trust members (3 million) will “strengthen local accountability”. That particular Emperor is not wearing any clothes, chaps.

The comedy bit on the National Care Service
Oh God, the bit on the National Care Service. Deep breath: here come the clichés.

It’s a fiesta for devotees of management-speak bullshit bingo: “care … will be transformed”; “we will develop a skilled and highly motivated workforce. The first stage of reform will be to create a step-change …”; “ … funded through savings and efficiencies in the health budget and in local government. During the next Parliament, the second stage of reform will centre on the development of national standards and entitlements to ensure high-quality care for all, and an end to the unfair postcode lotteries that affect too many families”.

The money, did you say? Ah, well, that comes from the aforementioned “savings and efficiencies in the health budget and in local government”, in the case of care at home.

As for the plan to “cap the costs of residential care so that everyone’s homes and savings are protected from care charges after two years. We will pay for this through our decision to freeze Inheritance Tax Thresholds until 2014-15, by supporting more people over the State Pension Age to stay in work if they so wish, and through efficiencies across the NHS and the care system”.

And the “comprehensive” NCS system (usefully, “to arrive after 2015”)?

Well, that is firmly in the long grass: “At the start of the next parliament we will establish a Commission to reach a consensus on the right way of financing this system.

“The Commission will determine the options which should be open to individuals so that people can have choice and flexibility about how they pay and to ensure that the National Care Service is funded in a fair way.

“The Commission will make recommendations in time for implementation of the third stage of reform after 2015, once these proposals have been put to the public at a general election”.

To recap: the money will come from savings and efficiencies, freezing IHT thresholds until 2014-15, and a system yet to be determined.

How could anybody not be confident, eh?